The task of the cosmetician is not only to provide a short-term improvement of the skin but also to effectively support the prevention of skin diseases.

Therapy and healing of skin diseases become more and more expensive. On the other hand, the health awareness constantly is increasing. According to experts, the prevention of diseases will be the future growth market. The costs for the treatment of diseases are paid by the health insurance; however, the single person is responsible for the prevention of diseases.

Prevention - the domain of the beauty institutes

As far as skin diseases are concerned, the prevention is the domain of the beauty institutes. Consequently, they now have the opportunity to expand the traditional job profile of a short-term superficial improvement to a long-term and causal preservation of the skin.To give the skin what it really needs is today's trend and the developments of the cosmetic industry are already a response to it as the critical judgment and the replacement of different components of cosmetic products are more and more important.A preventive-oriented skin care deals with the ingredients and their INCI declaration as this is the only way to judge whether the products used really are supporting the prevention e.g. of allergic reactions.Beauty institutes benefit from the cost budgeting of dermatologists who only have little room left for the preventive care of skin problems. They are in a dilemma of prescribing inexpensive products which show visible results on the short-term.This leads to the fact that inexpensive steroid products are prescribed to an increasing extent. As a consequence, a growing number of clients of beauty institutes can be observed which are not complaining about acute skin diseases but about an unstable skin condition due to the steroid treatment.Generally, a steady increase of sensitizations caused by additives in cosmetic and dermatological products can be realized. Top positions take perfumes and preservatives. At first glance this trend cannot be understood as the knowledge on effects and side effects of additives has been increasing considerably, and as it turned out that there is an alternative to these substances.

Besides treatment, consultation is important too

As a background here, usually cost reductions in both, the field of raw materials and preparations of mass products have to be mentioned. This opens up an extensive activity field for consultation and treatment within the general scope of prevention besides the traditional core business of decorative cosmetic and the wellness sector. However, the precondition here, as already mentioned above, is a very intensive study of the dermatological and chemical context. Casual clients will only become regular clients, if the prevention of their skin problems also became noticeable just like it was promised.As every skin has its individual conditions and also local differences, and in addition to that also different factors have to be considered for skin disorders like e.g.

bad skin

skin susceptible for neurodermatitis

skin susceptible for ichthyosis

skin susceptible for psoriasis

pruritus

skin with multiple intolerances,

conventional products only allow a successful consultation and treatment for a limited part of the clients.

Systemic skin care with coordinated products

This is the chance for skin care systems, which allow a combination of appropriately coordinated products. It should be paid attention to the fact that a cosmetician only is allowed to treat the healthy skin.Example: A base cream is used, which e.g. can be supplemented with a liposome concentrate for the care of bad skin or the prevention of bad skin. Advantage: the liposome concentrate can be applied on isolated sensitive areas.Example: For the prevention of a skin susceptible for occupational dermatosis, an emulsifier free cream is recommended as in those cases the skin barrier is very unstable and would additionally be disturbed by emulsifiers. The treatment can be supplemented with nanoparticles containing primrose oil and urea. This procedure also has proven successful for a skin susceptible for neurodermatitis. In cases of tense skin which may lead to itching, pure oil, e.g. jojoba oil can individually be applied. The application of an appropriate base cream before the oils results in the fact that the oils are very well absorbed by the skin and will not leave an oily film. Also dry skin has to be taken care of to avoid cracks where bacterial or fungi infections may develop.Example: hypersensitive skin "not tolerating anything". A good portion of instinct is necessary to find out which substances are tolerated or not tolerated. In these cases sometimes even differences in the concentration of a substance or the osmotic pressure decides on the fact whether or not a substance is tolerated. Additionally there is a considerable psychological effect if the client has the feeling that the cream is of use. She tends to apply the product more and more intensely.The psychological competence of the cosmetician is needed to explain the client with all her empathy that less is sometimes better.

Base creams

In this connection base creams are very helpful which are used in the pharmacy for dermatological prescriptions as well as in the beauty institutes.With regard to the composition it has to be taken care that these creams should be free of mineral oils to prevent that the unnecessary occlusive effects combined with it slow down the self-regeneration of the skin. It can be taken for granted that the production of own natural barrier substances is the best guarantee for a successful prevention. As the natural skin barrier layers are disturbed by emulsifiers, modern emulsifier free products should be preferred. The selection of products should be made in view of the ingredients (INCI declaration) instead of the slogans of the manufacturers. It is also recommended to ask the manufacturers in case of any doubts regarding the concentration or quality of the substances.For further information on the properties of components neutral sources should be preferred. Caution concerning the information of the competitors or customer advisory services or institutes cooperating with manufacturers basically is advised. An excellent reference book for most of the substances used and their properties is the "Lexikon für Hilfsstoffe für Pharmazie, Kosmetik und angrenzende Gebiete" by H.P. Fiedler, published in the Editio Cantor Verlag, Aulendorf. It excels by a multitude of references on technical literature.Regarding the publicity for the institute it should be kept in mind that the limits set by the cosmetic decree have to be observed although the institute may be very successful in the field of prevention. Prevention does not mean healing but it makes healing superfluous.

Intensive consultation

The cosmetic consultation is very important especially in the field of preventive care. It is increasingly necessary to learn about the day to day habits of the clients to get a grip on skin disorders which are caused e.g. by nutrition, clothes, materials around the workplace or washing habits. The clients will be grateful and the loyalty to the institute will increase. To make a final remark: preventive skin care has to do with skin protection. Skin protection means to protect the skin against the penetration of extremely harmful substances. Also the availability of active agents is mentioned herewith.Modern systems achieve both: they let penetrate cosmetically active agents and protect the skin from exogenous, undesirable substances.

Dr. Hans Lautenschläger

Please note: The publication is based on the state of the art at the publishing date of the specialist journal.